Clustering of Risk Factors in Parents of Patients with Type 1 Diabetes and Nephropathy

Lena M Thorn; Carol Forsblom; Johan Fagerudd; Kim Pettersson-Fernholm; Riika Kilpikari; Per-Henrik Groop

doi:10.2337/dc06-2033

Clustering of Risk Factors in Parents of Patients with Type 1 Diabetes and Nephropathy

Lena M Thorn, MD^1,,²,
Carol Forsblom, DMSc^1,,²,
Johan Fagerudd, MD, DMSc^1,,²,
Kim Pettersson-Fernholm, MD, DMSc^1,,²,
Riika Kilpikari, MSc¹ and
Per-Henrik Groop, MD, DMSc (per-henrik.groop{at}helsinki.fi)^1,,² on behalf of the FinnDiane Study Group

¹Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland
²Department of Medicine, Division of Nephrology, Helsinki University Hospital, Finland

Abstract

Abstract OBJECTIVE - To assess the impact of parental risk factors for diabetic nephropathy (DN).

Abstract RESEARCH DESIGN AND METHODS -- In this cross-sectional study, 2,355 type 1 diabetic patients from the FinnDiane Study were included. DN was defined as macroalbuminuria (urinary albumin excretion rate >200μg/min or >300mg/24h) or end-stage renal disease. Information was available from 4,676 parents. Parental scores were calculated, based on the number of various traits in the parents.

Abstract RESULTS - Patients with DN, compared to those without DN, had a higher prevalence of maternal (41% vs. 35%, P=0.046) and parental hypertension (62% vs. 55%, P=0.044), maternal stroke (7.6% vs. 5.1%, P=0.044), as well as maternal (1.4% vs. 0.7%, P=0.058), and parental type 1 diabetes (4.3% vs. 2.9%, P=0.030). If both, compared to none, of the parents had hypertension, the adjusted odds ratio for DN in offspring was 1.56 (95% CI 1.13-2.15). The adjusted odds ratio for DN was 2.13 (1.36-3.33) for the parental hypertension-diabetes score (3-4 vs. 0 points) and 2.13 (1.37-3.33) for the parental hypertension-cardiovascular disease-diabetes score (4-6 vs. 0). Fathers to patients with DN, compared to those without DN, had reduced overall survival (P = 0.04, Log rank) and reduced cardiovascular survival (P = 0.03, Log rank).

Abstract CONCLUSIONS - A cluster of parental hypertension, CVD, and diabetes is associated with DN in type 1 diabetes, as is paternal mortality.